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I’m working 96 hours this week, so I am practically living at my Woburn EMS base. I am hoping to document at my primary hospital, Lahey of Burlington, a level 1 trauma center.

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This is P2, the paramedic fly car that covers the Woburn area. With this, we will show up on medical scenes and intercept with moving ambulances in need of paramedics.

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This image shows the distance between my base in Woburn and Lahey Hospital. I have the privilege of being the paramedic covering Woburn, which is luckily very close to a high level hospital like Lahey. 

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This is the Burlington Fire Department’s ambulance in the Lahey Hospital ambulance bay. We intercepted with them to help stabilize a stroke patient. 

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Sight: Today, I see EMTs and paramedics socializing, as well as wheeling in patients. I see doctors and nurses leaving their shifts or taking lunch.

Sound: From day to day, the most profound noise surrounding this bay are blaring sirens in the distance. It is an unspoken rule that ambulances will not run their sirens immediately next to the bay, which is highly beneficial for someone like me who has already suffered minor hearing loss due to the occupation. Occasionally, I’ll hear a patients screaming at my colleagues or simply out of pain. I occasionally will see and hear the helicopter land and take off; the patients who occupying this helicopter are in very poor health.

Smell: You might expect the ambulance bay a trauma hospital to have an overwhelming smell of blood and other bodily fluids. Strangely, this is not the case. There are two to three smells I notice every day: the odors of diesel, gasoline, and latex. Often I wonder about the long term health effects of such profound exposure.

Taste: One part of working in this field is finding anything you can to keep you up at late hours of the night, or just on a long shift. I taste the Zyn I have on my gum line, effectively keeping me up when I’m feeling tired. I think that nicotine addiction is a problem in EMS, whether that be cigarettes, vapes, dip, or Zyn. Outside of other hospitals, medical personnel can be smoking, though Lahey seems not to allow this.

Touch: I feel the cold metal handlebars of the ambulance doors pressing on my hands covered in latex gloves, which have filled with sweat since the AC was broken in the last ambulance I rode with. I used to sweat from anxiety on particularly acute calls, though in the hot days of recent, it’s hard to tell.

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This is a Boston Med Flight critical care helicopter. If you’re ever very unlucky in the state of Massachusetts, you may find yourself in one of these. The helipad in this image is at Lahey.

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My bed at the Woburn base. Although it doesn’t look it, it’s the most comfortable bed in the world at 3 AM. 

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Sleep is always a concern in EMS, especially among paramedics. Out of the 96 hours I work this week, a great chunk is spent doing school work, and even more is spent sleeping. Still, EMS sleep equates to sleeping light. At any moment, the radio may go off, requesting my presence at a highly acute medical scene. This leads to me needing further sleep when I get home, even if I’ve already got 9 hours while on the job. I’ve started to wonder about the psychological impact of such sleep, as I’ve had nightmares each of the last two shifts I’ve worked.

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EMS workers, and in particular, paramedics, see people in states that the human brain is not naturally equipped to handle. I know I am bound to see the worst in humanity at my job, and I know that’s where I can help the most. Still, the encounters I have every day can be extremely challenging to handle after the fact.

As I have discussed, addiction is prominent among EMS workers. I can attribute this to the hours, the traumatic experiences, or generally the culture. I have many friends and colleagues battling alcoholism, and that in itself pains me.

Further, I think that childhood trauma can predispose people to working in this field. For some, they may want to relive and change a similar situation to what they had experienced. Others may run head first into such a profoundly emotional job as a distraction.

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Lahey Hospital has been recently renovated and is theoretically as capable as any major Boston hospital. It is staffed very well and has strong patient outcomes. I feel confident in bringing almost all of my patients here.

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Going through the last day of work with the health of my community localized to EMS, has shown me the great deficiencies in well being that many healthcare providers have.

Something I’ve noticed today is that we need to treat each other better in this community. Not only is there hazing of new hires, but I’ve seen experienced providers be picked on by others.

I agree with my assessment of addiction and mental health from earlier, and think that a potentially toxic work environment only adds to that problem.

Further, obesity in EMS is not something I have discussed in full. The notion of a provider at an unhealthy weight creates a similar dichotomy to the one smoking cigarettes or having an addiction issue.

In summation, I think of EMS in the context of an airplane: Do not apply the oxygen mask to someone else before you have secured it on yourself. We cannot best help others if we have not helped ourselves.

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Zyn, as I discussed in my Day 1 impressions. Highly flavorful and even more addictive. 

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Nicotine, as I have discussed, is very prominent in my field. A lot of EMTs and paramedics suffer from nicotine dependence and generally live in poorer health. Obesity is also prominent, as is alcoholism and even narcotic addiction. This creates a tragic paradox where healthcare providers are potentially as unhealthy as their sicker patients. I worry for my senior providers, who tend to be the greatest sufferers.